examine the effects of meditation on daily psychological stress responses in woman with a history of child adversity

Conditions: Stress; Psychological Stress; Child Maltreatment; Depressive Symptoms; Signs and Symptoms; Psychological Distress; Psychological

Summary: the aim of the everyday moments of mindfulness (emmi) study is to test whether brief mindfulness-based practices will improve daily psychological stress responses in women (age 30-60) who report a history of early life adversity. following a baseline visit (remotely or in person), participants complete daily surveys and audio-guided mindfulness-based practices in everyday life via the study app. specifically, participants receive app-notifications three times/day (morning, afternoon, evening) to complete daily surveys of current stressors and psychological states. at each notification, each participant is then randomly assigned to either receive a mindfulness-based intervention or not (max of 3 interventions/day). thus, participants are randomized many times over the course of this 30-day study. at the end of the study, participants complete a follow-up visit (remotely or in person).

the aim of the present study is to test whether brief app-based mindfulness and compassion practices will improve daily psychological stress responses in a sample of adult women (age 30-60) who report a history of early life adversity. the study will incorporate surveys and mindfulness-based intervention practices into everyday life using mobile technology (study app). participants receive app-notifications three times/day (morning, afternoon, evening) to complete ecological momentary assessments (emas) of current psychological stress states (pre-ema; e.g., stress appraisals, affect, perseverative cognitions, self-criticism, social connection). at each notification, each participant is then randomized to either receive a mindfulness-based intervention (described in detail below) or no intervention. thus, each participant is randomized many times over this 30-day study (micro-randomized trial, mrt). psychological stress states are again measured approximately 15 min post-randomization (post-ema; e.g., stress appraisals, affect, perseverative cognitions, self-criticism, social connection) to assess a treatment effect by comparing psychological stress responses after a mindfulness-based intervention vs. no intervention. the mrt will continue for 30 days. all study participants will be asked to fill out questionnaires at baseline and post-intervention (after 30 days). weekly measures of depressive symptoms are also obtained. a trained research assistant will monitor participant adherence and address potential difficulties. mindfulness-based intervention: the intervention consists of mindfulness and compassion-based practices. for example, practices focus on the breath/body (e.g., 3 minute breathing space; compassionate body scan; five senses mediation), on increasing participants' inner resources (e.g., imaging a safe person or safe place), on reducing negative affect (e.g., self-compassionate and acceptance-based practices), or on increasing positive emotions (e.g., gratitude practice; metta practices). all interventions are brief (≤5 minutes) and audio-guided.

Eligibility criteria:
inclusion criteria: * female gender * age 30-60 * reports at least two adverse childhood experiences on the 10-item adverse childhood experiences (ace) scale * reports at least mild depressive symptoms (patient health questionnaire ≥ 5) * has access to a personal smartphone exclusion criteria: * non-english speaker or unable to provide informed consent * current regular mindfulness practice (exclude if \>20 min/week) * diagnosis of severe psychiatric disorders, including psychosis/schizophrenia, bipolar disorder, post-traumatic stress disorder (ptsd), alcohol/substance-use disorder, major depressive disorder (phq-9 ≥ 15), and self-harm or suicidal ideation (phq-9, item 9). * unstable medication use and psychotherapy treatment (\<3 months).

Keywords: mindfulness adverse childhood experiences stress appraisals affect daily psychological stress responses stress depressive symptoms